Money makes a difference in Canadian health care – but what if that can change?

For Canadians who are used to decades of socialized medicine starting with Tommy Douglas’Hospital Services Plan in 1947, the brouhaha over financial barriers to access in American health care might seem quite odd. But what many Canadians may not realize is that while we have “universal health care” in principle in this country, financial barriers are still a huge problem when it comes to people’s ability to access care.

The cost of medications is a key component of this struggle, particularly for patients with chronic diseases like hypertension, diabetes, and heart disease who need to be on medications for several years to ward off further complications. More than one in ten adults in Western Canada with cardiovascular-related chronic conditions report a lack of drug coverage and perceive cost-related barriers.

Patients with these barriers are less like to receive recommended medications, more likely to be non-adherent (i.e. not taking prescribed medications), and have more hospitalizations or emergency department visits. Similarly, evidence from the United States indicates that financial barriers to health services and medications are associated with worse recovery after a heart attack, in the form of worse chest pain, poorer quality of life, and a higher risk of readmission to hospital. In other words, we may be able to come up with the best care plan for our patients, but it won’t really make a difference if the patients cannot afford the medications being prescribed.